Bupa cash plan:

Making a claim

Step 1 of 3

Please enter your details below to begin your claim. Make sure you have everything you need to complete your claim before starting.

You’ll need: your membership number, a copy of your receipt, your provider/practitioner details, and your bank details.Please refer to your Membership Guide to check which benefits you’re eligible to claim for. If you have any problems with completing this form please contact us on 0345 606 6003. Lines are open Monday to Friday 8am to 6pm, Saturday 8am to 1pm. We may record or monitor our calls.

*mandatory field

Enter your Bupa membership number*

Member details

Who is the claim for?*

Enter the claimant's personal details:

Name*

Date of Birth*

Gender:

Main member personal details:

Name*

Date of birth*

Policy holders contact details:

We recognise that when you give us personal information (which includes health information) you’re trusting us to take good care of it. Please see our privacy policy for more information about how we collect, use and protect your data.

If you don’t want to receive marketing about Bupa products and services that we think are relevant to you, please contact us at optmeout@bupa.com

Bupa cash plan:

Making a claim

Step 3 of 3

Please provide your payment details below.

We’ll keep your details safe by processing your claims securely.
If you have any problems with completing this form please contact us on 0345 606 6003.
Lines are open Monday to Friday 8am to 6pm, Saturday 8am to 1pm. We may record or monitor our calls.

*mandatory field

Payment details

Enter your account details:

Account holder name*

Bank/Building Society name*

Sort code*--Please provide a valid sortcode

Account number*

Please read the following carefully before agreeing to declaration

Before submitting the claim form please study your membership guide as it relates to your claim.
Please note that we’re not responsible for the costs of obtaining documentation in support of the claim.
The information on this form will be used by us to deal with any claim. In order to detect, prevent and help with the prosecution of financial crime, we may share information with fraud prevention or law enforcement agencies and other organisations.
If we suspect fraudulent activity we may inform the person or organisation who administers or funds your Bupa services.

Declaration:

By submitting this claim online, I am authorising Bupa to make payments to the account referenced above.

I consent that Bupa Cash Plan may contact my practitioner/provider/consultant to obtain clinical records that can be used to support this claim.

I declare that the information contained within this claim is true and correct to the best of my knowledge and belief.

I have not withheld any information from Bupa within my knowledge connected with this claim.

I confirm that I’ve read Bupa’s Privacy Notice and have made any other claimants aware of this for claims relating to their treatment.

By submitting this information, I confirm that I am doing so with the knowledge and permission of the Main member.
I agree to provide any further information or documentation as may be reasonably required.

I agree

Please accept terms and conditions

Submitting your claim

Bupa cash plan is provided by Bupa Insurance Limited. Registered in England and Wales No. 3956433. Bupa Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Arranged and administered by Bupa Insurance Services Limited, which is authorised and regulated by the Financial Conduct Authority.